Today I did an arterial surgery follow-up appointment at the University of Washington. UW didn’t do the surgery, but they’re far more convenient than Stanford, and they do have a baseline of pre-surgery testing I did in 2019.
For this evaluation, they did a CT scan followed by an exercise stress test followed by a visit to the doctor. The CT scan was more unpleasant than I remembered: First, my vein was scarred, so they had to poke through the scars, which hurts quite a bit.
Not as much, though, as when the indicator goes in. THAT stuff burns. They warn you, “It’ll feel warm, and you’ll feel like you peed your pants.” (This is true, because when the indicator reaches the groinal region, well, it makes it warm. The only time you feel that is when you pee your pants. Hence your brain interprets that as pee.) It doesn’t feel warm in the arm; it feels like red-hot needles pushing down the vein. Super unpleasant.
After that, I got to do a lot of ultrasounds for the stress test. They first did a resting ultrasound measuring my various arteries, then I ran on a treadmill – 2 minute warm up, 3 minutes at 6.6 mph and 5%. That was enough for me to be feeling it pretty noticeably in my left leg. So it was time to hop off and measure everything again.
At the consult with the doctor, I got the results: The artery is still spasming, even though it shouldn’t be able to with the patch. But the patch is essentially preventing it from spasming all the way shut, so I’m getting some blood flow through. That’s why this round isn’t as painful as previously.
Surgical options aren’t real clear, since the surgeon literally said, “Wow, this is strange, I’ve never seen this before,” and “It’s not supposed to be able to do that!” when she looked at my imagery. Not something you want a surgeon to say about you.
- The first option would be another patch, but that would be difficult, since the artery has already been patched once.
- The second option is to replace the entire segment with a Dacron bypass, but that comes with additional hazards that I’m not keen to take on.
- The third option would be to use a vein to create essentially another channel for blood to flow through, bypassing the artery but leaving the patched artery in place. That alternative route is probably the safest, but over time it might (likely? doctor didn’t say) clot off, leaving me back where I am now.
I opted for Option 4: Wait and see. The fact is that I can do 90% of what I want to with the artery I have right now. As long as it doesn’t get worse, I’m disinclined to go do more surgery in that area.
BUT. Here’s the sticky wicket: At some point soon-ish, I have to have surgery there anyway, to repair a frickin’ humongous surgical hernia that I have left over from the original surgery. The ultrasound technician who initially imaged it made alarming comments about how huge it was, and the radiologist who gave me the results shared this “reassuring” thought: “Well, the hole is so big, you’re not in any danger of having your bowel trapped in it.” Small mercies, I guess?!
I have yet to see a hernia surgeon; that’s the next to-do item.
The thing is, if I’m going to go under general anesthetic and do the whole nine yards of surgery for the hernia repair, why not go in and do Option 3 for the artery at the same time? It’s the least likely to cause collateral damage, and worst case, it eventually clots off — probably leaving me right where I am now, but more years (and miles) down the road.
Bottom line is that the surgery was not totally successful, but the patch is doing some good. Some blood continues to flow in that artery, where before it didn’t. In six months we’ll measure where I’m at again and see if there’s any change. That’ll provide the data I need to make a fully informed decision.
I really don’t want to wait more than another six months to deal with this hernia, now I know what it is and that all those sit-ups probably just made it worse. Darn it!